Rob Waters (RW): Manu, Governor Deval Patrick recently announced the next phase of the Mass HIway Health Information Exchange. What’s been your role in the preparations for the launch and what new tools will providers and other stakeholders now have access to?

Manu Tandon (MT): The new enhancement to the Mass HIway will enable participating providers to query, locate, and retrieve patient records. It is important to note that Massachusetts has taken an ‘opt in’ approach, meaning that patients must provide consent to their health care organization to publish their relationships to Mass HIway. Our aim over the coming years is to assist participating organizations with the consent process and populate the Relationship Listing Service in order to make this valuable for the healthcare community at large. We see this as a cornerstone technology to enable the administration’s policy goal of reducing costs and enhancing quality in the health care system in Massachusetts. As to my role, working with a very talented team, I have led the development and operations of Mass HIway.

RW: Many state HIEs are now looking at value added tools including reporting and advanced analytics that will support the development of ACOs and primary care coordination, is this a direction that Mass HIway is also be taking?

MT: Our approach to the HIE is that we see it as a safe and secure conduit that connects several nodes. Sort of like a mailman with security. While providing advanced analytics services does not directly fall in the box of being a conduit, we certainly see such services being added as nodes on the HIE. We encourage public and private solutions that provide this service to connect to the Mass HIway. For instance on the Medicaid side, we are working on a project to attach a Quality Data Repository (QDR) and Quality Analytics solution to the Mass HIway. I think the question is less about our ability to transmit and capture quality data and more about the electronic health record’s ability to produce quality data that is programmatically relevant for ACOs. I think we need to move beyond Meaningful Use on this account.

RW: Data privacy and security agreements is always a challenge when introducing new services to healthcare stakeholders, were there any new measures that were introduced along with the latest service rollout at the exchange?

MT: Massachusetts is ‘opt in’ so additional patient consent must be obtained and documented for use of Query and Retrieve, which encourages a meaningful dialogue between patient and provider on privacy and security. Most organizations in Massachusetts already have experience obtaining patient consent so for the most part, the community has been learning from each other.

There are several elements that greatly enhance the security of the Mass HIway over traditional methods of sending and receiving personal health information, such as fax, mail, or usb drive. These elements include message encryption end to end so messages can only be read by the intended recipient, built in audit logs to track users who have accessed a patient’s relationship list, and user authentication through unique IDs and strong passwords. It’s important to note here that the Mass HIway does not store any personal health information. Storage of health records remains with the patient’s institution. All participants of the Mass HIway sign an agreement to comply with all security and privacy requirements required by law, and patients can speak with their healthcare providers to discuss security measures in place at the site level.

RW: You’re also responsible for the coordination of HIT for Medicaid and other human services agencies in Massachusetts, will this next phase of implementation at the Mass HIway impact any of the other programs you’re involved with?

MT: The goal is to bring state agencies into better alignment on healthcare quality metrics and related data so key agency programs can rely on consistent, actionable information and providers can avoid sending the same information to multiple agencies. The Mass HIway will serve as a mechanism to improve quality measurement data collection and reporting across the state and within our health and human services agencies. Health information technology offers tools to support pay for quality programs and health care innovations to drive the next phase of health reform- improving quality while controlling costs. In addition, Mass HIway will deliver a provider directory solution that we intend to leverage for other health and human services programs in Massachusetts.

RW: In your own personal vision for the Mass HIWAY, what excites you about the future potential for the role of the exchange in 5 years from now?

MT: As a citizen, I am tickled by the possibility of healthcare data liquidity with full privacy and security controls for better health outcomes. As an executive, I am convinced that our vision is the right one and am satisfied with the fiscal, technical, programmatic, and stakeholder alignment we deeply enjoy in Massachusetts. The manager in me though knows that we are not there yet. We have much work to do over the next 5 years as we continue to work with electronic health record vendors and participating health care organizations to bring the full value of the Mass HIway to fruition. By building upon the success of over 65 live participants, 1.8 million transactions that have traversed the Mass HIway, and leveraging the success of our early adopters of Query and Retrieve, we look forward to making the Mass HIway the ubiquitous, seamless solution it is envisioned to be in Massachusetts. I remain strongly optimistic that this tool will play a key role in making a real impact on patient health outcomes and lowering costs in the health care system. In the end, that is what drives us.